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28 September 2010

Characteristics and prognosis of post-transplant lymphoproliferative disorders within renal allograft: Report from the PTLD.Int. Survey

Hossein Khedmat, Saeed Taheri

Ann Transplant 2010; 15(3): 80-86 :: ID: 881170


Background: Post-transplant lymphoproliferative disorders (PTLDs) can occur within the allograft, representing a differential diagnosis for an acute rejection episode; in this study, we collected data from PTLD patients involving kidney allografts, and compared their characteristics with other renal transplant patients from the same centers who developed PTLDs localized elsewhere.
Material/Methods: A comprehensive search was made by Pubmed and Google Scholar for reports of lymphoproliferative disorders after renal transplantation. Data from 17 studies were included into analysis. Having at least 1 patient with renal allograft involvement by PTLD was inclusion criterion. Data for patients was collected by use of a standard questionnaire.
Results: PTLD complicated renal allograft in 46 (37%) of our study population. Renal transplant recipients with allograft localization of PTLD had better survival than other PTLD patients unless they developed multi-organ involvement (p=0.007). Five-year survival rate was 73% for graft PTLD and 42% for other localizations. Graft PTLD patients had shorter time from transplant to PTLD (p=0.01) and were more likely to present as polyclonal and polymorph in their histological evaluations (p<0.05).
Conclusions: Renal transplant recipients who develop allograft dysfunction during the early post-transplantation period should get full evaluations for a potential PTLD development at their allograft site. Before development of multi-organ involvement allograft PTLD in renal transplant patients has a benign behavior; therefore it is crucial to evaluate renal recipients with initial symptoms of PTLDs.

Keywords: renal allograft, post-transplant lymphoproliferative disorders, renal transplantation


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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358